Insights from US President Joe Biden’s chief medical adviser, Anthony Fauci, who served on the White House Coronavirus Task Force at the height of the pandemic, on the end of COVID-19, the danger of China’s recent surge in cases, preparedness for future pandemics, and the misinformation in the US that has led to a lack of trust in science.


As director of the US National Institute of Allergy and Infectious Diseases (NIAID) and a key member of the White House Coronavirus Task Force under Donald Trump, Fauci confronted some of the pandemic’s most challenging moments. At the FT The Global Boardroom earlier this month he shared some key insights.


It’s not over yet

With respect to the growing sensation in many parts of the world that COVID-19 is behind us, Fauci, who will be leaving his US government role at the end of the year to retire, said: “I think it would be premature and inappropriate to say that we are done with [the pandemic].”

 I think it would be premature and inappropriate to say that we are done with [the pandemic]

For Fauci continuing with the public health measures that have proven effective is vital. “We still have to be on our guard and implement the public health measures that are available, like vaccination,” he said. And although new variants can still arise, Fauci put forward that current booster shots do offer cross protection that should impact the level of infection severity.

Regarding the future of the virus, Fauci was cautious. “There is a possibility and perhaps even a likelihood that after a period of time, hopefully, sooner rather than later, that the coronavirus causing COVID-19 … will essentially go into that group of respiratory illnesses, like the flu, that are present, not disappearing, but that don’t disrupt society the way COVID-19 has,” he stated.


China’s Zero-COVID strategy and outbreak

About the zero-COVID strategy China abruptly exited from, Fauci was critical. “If you are going to shut down, you do it for the purpose of doing something so that you can open up, like vaccinating as many people as you possibly can as quickly as you possibly can.”

He predicted a wave of infections that could strike China’s elderly population, a population that is largely not protected against the Omicron variants, and people with underlying health conditions. Echoing the view of the current White House coronavirus coordinator, Ashish Jha and in light of the limited efficacy of Chinese vaccines, he also said that Western vaccines are needed. “I would suggest that they import western [vaccines], particularly the highly effective mRNA vaccines that are used in most countries in the world.”

According to Fauci, the surge in infections in China could have an impact beyond the country’s borders. “Whenever you have a large wave of transmissions of a virus, you give it ample opportunity to mutate. And when you give a virus opportunity to mutate, that allows it to form potentially new variants. And once you get a brand-new variant that could have an impact on the rest of the world,” Fauci commented.


Trust in science

Fauci applauded the scientific prowess that brought a COVID-19 vaccine forward in less than a year as contrasted with the misinformation that has led to widespread mistrust of scientific proof for social distancing measures and vaccines, particularly in the United States.

“We have to reignite and regenerate the trust in science and with it the trust in evidence, facts and data and put aside what I call the tsunami of misinformation and disinformation that was seen to variable degrees throughout the world but rather intensively in the United States,” he stated.

Critical of how public health has been politicized in favour of ideological views, Fauci said: “Vaccines, unequivocally, whether you’re a democrat, a republican or an independent, are a highly effective way of saving lives and people not implementing that because of a political ideology is contrary to all public health and even moral principles.”

In further discussion on the distrust that has developed in the US, Fauci spoke about the harassment people who work in public health have been subjected to, including Fauci and his family who continue to be exposed to attacks. “[What is] troubling is the attacks on healthcare providers and people who are in the public health field by people who would harass them because they believe the implementation of public health measures was an encroachment on their freedom.”


Preparedness for future pandemics

Certain of the eventuality of future pandemics, Fauci stressed the need to prepare ourselves now. “My concern is twofold. To get out of the situation we are in right now and we can do that, but also to prepare ourselves for the inevitability of another pandemic. It might not occur in a year, in 5 or ten but it will occur,” he said.

Let’s hope we don’t forget and not heed the lessons of this horrible experience that our world has gone through

That preparedness starts with international collaboration, which, according to Fauci is achievable and should still be extended to the search for the origin of the SARS‑CoV‑2 virus and the cooperation between scientists outside of China with Chinese scientists.

However, the foundation for preparedness, for Fauci, is building up healthcare infrastructure around the world. “The thing that is going to require the investment of years if not decades is to build up the healthcare and health system infrastructure throughout the world so that you can implement the distribution of vaccines in lower and middle income countries.”

About the role of the World Health Organization (WHO), Fauci recognized the organization’s efforts over the past two years but expressed a need for continued progress. “They need to continue to self-examine and improve. Also, they do need support from the member nations,” he said.


Photo credit: Daniel Soé Photography